| NPI | 1538481593 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRVIN WIESMAN Sole Member 773-275-5550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| Enumeration Date | 2010-02-18 |
| Last Update Date | 2010-02-18 |